Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #106912

Tung T. Nguyen, MD¹, Stephen J. McPhee, MD¹, Ginny Gildengorin, PhD², Thoa Nguyen³, Ching Wong³, Ky Q. Lai, MD, MPH⁴, Hy Lam³, Thien-Nhien Luong, MPH⁵, Ngoc Bui-Tong, MHA⁶, and Tuyet Ha-Iaconis⁷. (1) Division of General Internal Medicine, University of California, San Francisco, 400 Parnassus Avenue, Box 0320, San Francisco, CA 94143, 415-502-1539, tung@itsa.ucsf.edu, (2) Medical Effectiveness Research Center for Diverse Populations, University of California San Francisco, Box 0856, 3333 California Street, Suite 335, San Francisco, CA 94143, (3) Division of General Internal Medicine, Vietnamese Community Health Promotion Project, University of California, San Francisco, 44 Page St, Suite 500, San Francisco, CA 94102, (4) Vietnamese Community Health Promotion Project, University of California, San Francisco, 44 Page St., Suite 500, San Francisco, CA 94102, (5) Santa Clara County Public Health Department, 3003 Moorpark Avenue, San Jose, CA 95128, (6) Ambulatory & Community Health Services, Santa Clara County Valley Health Center, 2325 Emborg Lane, Suite 3H320, San Jose, CA 95128, (7) American Cancer Society, 1715 South Bascom Ave. Suite 100, Campbell, CA 95008

Vietnamese women have the highest incidence of cervical cancer in the U.S. They also underutilize Pap tests. The Vietnamese REACH for Health Initiative (VRHI) Coalition was formed and developed a Community Action Plan (CAP) to increase Pap testing among Vietnamese women in Santa Clara County, California. The CAP included 6 components designed to address barriers raised by Coalition and community members: a Vietnamese-language media campaign, lay health worker outreach, Vietnamese Pap clinic, Pap test reminders, continuing medical education for Vietnamese physicians, and efforts to restore a Breast and Cervical Cancer Control Program. Effectiveness was assessed by pre- and post-intervention cross-sectional telephone surveys of Vietnamese women age > 18 in Santa Clara County and the comparison community of Harris County, Texas (n=1,566 in 2000 and n=2,009 in 2004). Pap testing increased significantly in Santa Clara County (77% to 84%, p<0.001), but not in Harris County (74% to 71%, p=NS). In multivariate analyses, the intervention significantly increased Pap testing (OR = 2.02, 95% CI 1.37-2.99). Factors significantly associated with increased Pap testing included: longer residence in the U.S., having health insurance and regular site of care, having a respectful doctor, having a non-Vietnamese doctor or a female Vietnamese doctor, and recalling exposure to Vietnamese-language radio ads or newspaper articles about Pap testing. Factors associated with lower likelihood of Pap testing were: age > 65, having never married, less than high school education, and household income below poverty level. CBPR was successfully implemented among Vietnamese American women to increase cervical cancer screening.

Learning Objectives: At the conclusion of this presentation, participants will be able to

• understand that Vietnamese American women have a higher incidence of cervical cancer and that fewer Vietnamese Americans obtain Pap tests compared to their white counterparts;
• understand the application of community-based participatory research (CBPR) to the Vietnamese American community; and
• understand how CBPR has increased Pap testing.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.